The Safety of Our — and YOUR — New Operating Room

There is no doubt that seeking the right plastic surgeon for your aesthetic needs is crucial, ensuring he or she has the experience and credentials for your upcoming procedures. Those are the exact reasons I left for Paris, Los Angeles, New York City, and Brazil a few years ago to perfect my techniques in aesthetic plastic surgery for the benefit of my Toronto patients. This is also why I go to several aesthetic meetings every year — for the maintenance of skills, knowledge, and certifications.

That being said, one often-omitted and crucial component patients forget to consider is surgical safety. Where you will have your surgery is as important as who does your surgery. An excellent plastic surgeon is likely to operate in a safe operating room, which means one that has been accredited by a recognized certifying agency such as the College of Physicians and Surgeons of Ontario.

But the rules change over time. Did you know that, due to the higher risks of surgical infection, the following are no longer allowed in any new operating room in 2016 in Ontario, Canada?

A sink in the operating room

Venetian blinds in the OR

Carpets in the perioperative space

Unsealed surgical flooring

Baseboards in the surgical centre

Straight corners in the operative rooms

Each year, new requirements are established by the College of Physicians and Surgeons, and our Visage Clinic surgical centre, being the newest in Toronto, is proudly the most up-to-date surgical facility.

We were fortunate to find my Yorkville space on Hazelton Avenue pre-construction, as it allowed us plenty of time to plan the building, the flow of the clinic, and its amenities. It also allowed us to get the proper engineering expertise to ensure maximal surgical and anesthesia safety. For example, our 3-year project allowed us to plan for a robust all-inclusive clinic and surgical centre generator, connected to the limitless city supplies of natural gas, allowing the clinic — and the surgeries — to continue without stress or interruption should there be a power failure. We went above the requirements for a few hours of battery backup.

Having 15 years of experience and likely another 25 to 30 years in practice, I decided to invest long-term in quality and safety. We purchased all new medical equipment: an anesthesia machine, OR lights and beds, an electrocautery machine, leg compression devices, a sterilizing machine, and so on. We truly believe our patients will find comfort and reassurance in knowing that their anesthesia machine is new and not a 30-year-old refurbished antique.

We also decided to equip our facility with 2 overnight rooms to maximize our patients’ safety and recovery. Patients truly appreciate staying overnight with our 2 nurses, who can tend to their immediate postoperative needs, alleviating stress for their loved ones. Adding video monitoring and Netflix programming in the overnight rooms will positively enhance our patients’ journey at Visage Clinic.

We also decided to have a second waiting room, on the same floor as the surgical centre, to allow some quiet for our patients waiting for their surgery and their families, away from the hustle and bustle of the consultation space and medical spa area downstairs.

The clinic has 4 dedicated HVAC systems, allowing the highest control of air quality and maximizing comfort in the various “zones” of the clinic.

It should also be mentioned that Visage Clinic MD has a private and discreet exit where patients are taken to their car postoperatively to underground parking, perfectly incognito. Everyone is entitled to his or her own privacy.

Visage MD also has its own elevator for convenience but also for privacy. We have our concierge service 24/7, and the entire premise is under video surveillance. Did I also mention the complimentary valet parking we offer?

Many of the requirements or features for private clinics are unknown from the public, as the health system is covered (free) in Canada. Private centres have the same stringent guidelines as hospitals in Ontario. Those requirements are not covered by OHIP (the provincial health insurance plan) when performing cosmetic surgery. Those private clinic requirements are often invisible to the eye, but they will impact patient safety — your safety. Those, you will see, explain the higher fees cosmetic surgery is associated with, not to mention the fees for nurses and anesthesiologists and the cost of the medications and of running the business.

Here are some of the features required by the Ontario College of Physicians and Surgeons for 2016:

Infections, complications, sterilization checks, and other data are monitored and measured for patient safety.

Fire, earthquake, and other safety protocols are required and reviewed.

Drug tracking, expiration checks, and emergency medication supplies are kept up to date.

Standards are set so that deep levels of anesthesia are performed by a physician anesthesiologist.

All staffing positions are filled with certified or licensed individuals appropriate for the job.

A dedicated certified sterilizing technician is required.

Medical records are checked to make sure they’re complete and up to date.

Quality management to ensure best standards is conducted and reviewed.

Office protocols must be in place and are reviewed every year.

Patient care and treatment are reviewed periodically.

A patient’s bill of rights and responsibilities is available.

In a peer review every 5 years, surgeons and anesthesiologists serve as monitors for each other to make sure safety measures and standards of care are followed.

A backup generator must be functioning.

Clean air quality testing must occur regularly.

There must be a minimum of 15 exchanges of fresh air per hour in the OR and recovery room.

No seams in the floor unless manually and professionally heat-welded.

No Venetian-type window blinds.

All surfaces must be bacteria-resistant, including countertops, sheet-blinds, cabinets, and more. (We used Caesarstones, antibacterial sheet-blinds and curtains, and antibacterial wood finishes.)

All surfaces must be “fire-retarding,” including paint, wood, fabric, and so on.

Walls must be fire-retarding and sound-proof.

Dirty instrument room must be separate from the clean sterilizing room.

No sink allowed in the OR (sinks are dirty and prone to infection).

Positive air flow and negative pressure requirements are in place for infection control.

CSA-approved technologies, including the oxygen and medical air systems, and copper in-wall piping are required.

Contracts must be in place for professional cleaning of the clinic daily.

Proper and dedicated kitchen and changing rooms must be available for staff.

All new commercial spaces in Ontario have to abide by the new 2015 Accessibility for Ontarians with Disabilities Act; not only do the premises have to be accessible for patients with disabilities, but also for employees. Wider doors, corridors, and bathrooms are required, for example.

There is no doubt that having your procedure in a private setting is more enjoyable. Risks of infection are also lower in a private facility compared with a hospital that treats hundreds or thousands of sick patients. But if you’re planning to have plastic surgery in a private surgical centre, confirm that your surgeon will be operating in a facility that has been accredited by the College of Physicians and Surgeons of Ontario. Make sure it is also clean and properly maintained.

Minimize your risks by doing your homework well before the day of your surgery. The surgeon who operates in an accredited operating room probably cares as much about your safety as you do, and that’s comforting to know. I can assure you that safety and quality were at the top of my list when planning our beautiful plastic surgery centre on Hazelton, in Yorkville.